title: Patient factors associated with undergoing laparoscopic adjustable gastric banding vs Roux-en-Y gastric bypass for weight loss.
abstract: BACKGROUND
  Roux-en-Y gastric bypass and laparoscopic adjustable gastric banding are 2 commonly performed bariatric procedures in the US with different profiles for risk and effectiveness. Little is known about factors that might lead patients to proceed with one procedure over the other.
  
  
  METHODS
  We recruited and interviewed patients seeking bariatric surgery from 2 academic centers in Boston (response rate 70%). We conducted multivariable analyses to identify patient perceptions and clinical and behavioral characteristics that correlated with undergoing gastric banding (n = 239) vs gastric bypass (n = 297).
  
  
  RESULTS
  After adjustment for socio-demographic and clinical factors, we found that older patients (odds ratio [OR] 1.03; 95% CI 1.00 to 1.05) and those with higher quality of life scores and higher levels of uncontrolled eating were more likely to undergo gastric banding as opposed to gastric bypass. In contrast, patients with type 2 diabetes (OR 0.46; 95% CI 0.28 to 0.77), those who desired greater weight loss, and those who were willing to assume higher mortality risk to achieve their ideal weight were less likely to proceed with gastric banding. After initial adjustment, male sex and lower body mass index were associated with a likelihood of undergoing gastric banding; however, these factors were no longer significant after adjustment for other significant correlates such as patients' perceived ideal weight, predilection to assume risk to lose weight, and eating behavior.
  
  
  CONCLUSIONS
  Patients' diabetes status, quality of life, eating behavior, ideal weight loss, and willingness to assume mortality risk to lose weight were associated with whether patients proceeded with gastric banding as opposed to gastric bypass. Other clinical factors were less important.
authors.affiliation: Evans Department of Medicine, Section of Endocrinology, Diabetes and Nutrition, Boston Medical Center and Boston University School of Medicine, Boston, MA.
authors.forename: Caroline M
authors.initials: CM
authors.lastname: Apovian
authors.forename: Karen W
authors.initials: KW
authors.lastname: Huskey
authors.forename: Sarah
authors.initials: S
authors.lastname: Chiodi
authors.forename: Donald T
authors.initials: DT
authors.lastname: Hess
authors.forename: Benjamin E
authors.initials: BE
authors.lastname: Schneider
authors.forename: George L
authors.initials: GL
authors.lastname: Blackburn
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Jones
authors.forename: Christina C
authors.initials: CC
authors.lastname: Wee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D005260:Female; D015390:Gastric Bypass / Q000523:psychology*; D015391:Gastroplasty / Q000379:methods / Q000523:psychology*; D015438:Health Behavior; D006801:Humans; D010535:Laparoscopy / Q000523:psychology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009042:Motivation; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications / Q000523:psychology / Q000601:surgery*; D057240:Patient Preference; D011788:Quality of Life; D011795:Surveys and Questionnaires; D015431:Weight Loss; D055815:Young Adult
keywords: BMI; IWQOL-lite; Impact of Weight on Quality of Life-lite Questionnaire; SOS-TFEQ-18; Swedish Obese Subjects Three Factor Eating Questionnaire; body mass index